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Does the Proportion of Same-Day and 24-Hour Appointments Impact Patient Satisfaction?

Richter, Jason P. PhD; Downs, Lynn PhD; Beauvais, Brad PhD; Huynh, Peter V. MSA; Hamilton, Jessica E. BSBA; Kim, Forest PhD; Weigel, Fred PhD

doi: 10.1097/QMH.0000000000000121
Satisfaction and Quality of Care

Background: The relationship between open access and patient satisfaction is mixed. Our study is the first to assess the relationship between open access appointment scheduling and patient satisfaction in the Military Health System (MHS). It is also unique in that we examine both same-day and 24-hour access through a relationship with satisfaction.

Methods: We conducted a panel time-series analysis with general estimating equations on the Army population of outpatient facilities (N = 32), with 32 364 957 total observations. Our primary independent variables were the proportion of a facility's appointments within 24 hours and same day from July 2013 to May 2015.

Results: We identified that a higher proportion of same-day appointments is associated with increased patient satisfaction with the ability to see their provider when needed. We did not find the same result when examining access within 24 hours.

Conclusions: Open access appointment scheduling appears to have a greater impact on patient satisfaction with timeliness of care if that appointment is made the same day the patient presents to the facility. Facilities should consider opening more of their schedule to accommodate same-day appointments. This can result in less costly primary care instead of emergency department usage.

Medical Support Squadron Commander, 4th Medical Group, Seymour Johnson AFB, North Carolina (Dr Richter); Army-Baylor University, Fort Sam Houston, Texas (Drs Downs, Kim, and Weigel, Mr Huynh, and Ms Hamilton); Trinity University, San Antonio, Texas (Dr Beauvais). Dr Weigel is now at Lipscomb University, Nashville, Tennessee.

Correspondence: Medical Support Squadron Commander Jason P. Richter, 4th Medical Group, Seymour Johnson AFB, NC, 1050 Jabara Ave, Seymour Johnson AFB, NC 27531 (

We thank the US Army Medical Command's programming, analysis, and evaluation office for providing the data used in this study.

The authors declare no conflicts of interest.

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